- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,442.70 / $27,013.50 / $30,556.00
| Facility | | $17,442.70 | $27,013.50 | $30,556.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,610.68 / $26,659.34 / $36,640.19
| Facility | | $17,610.68 | $26,659.34 | $36,640.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,866.00 / $22,186.81 / $34,369.60
| Facility | | $15,866.00 | $22,186.81 | $34,369.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,496.00 / $22,446.00 / $32,361.00
| Facility | | $15,496.00 | $22,446.00 | $32,361.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,958.00 / $25,193.15 / $41,432.72
| Facility | | $4,958.00 | $25,193.15 | $41,432.72 |